Individual
GUY J IACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
617 UNION AVE, BRIELLE, NJ 08730-1838
(732) 977-3374
Mailing address
34 APPLE DR, SPRING LAKE, NJ 07762-2178
(732) 977-3374
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05779800
NJ
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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